Part B News Features
Question: I‘ve heard that, rather than waiting for a denial on a claim so I can request a formal appeal, I can ask to have my claim changed after I’ve submitted it to the Medicare administ... More
Question: A new patient came in and saw our physician assistant (PA) for some lacerations. She did not see a doctor. A week later the patient returned for follow up with an M.D. For purposes of billin... More
If you’ve been doing better on Medicare appeals lately, you’re part of a trend. Between 2013 and 2020, the overall rate of success for providers and suppliers on redeterminations, the firs... More
Question: I‘ve heard that, rather than waiting for a denial on a claim so I can request a formal appeal, I can ask to have my claim changed after I’ve submitted it to the Medicare administ... More
Question: A new patient came in and saw our physician assistant (PA) for some lacerations. She did not see a doctor. A week later the patient returned for follow up with an M.D. For purposes of billin... More
If you’ve been doing better on Medicare appeals lately, you’re part of a trend. Between 2013 and 2020, the overall rate of success for providers and suppliers on redeterminations, the firs... More
Tools
On Jan. 4, 2021, CMS updated the Part B conversion factor to $34.89, an increase of 8% over the previously finalized rate. The agency also revised total relative value units (RVU) for hundreds of services. Find the latest fees here.
Through the array of charts and data contained in this special report, you’ll find key characteristics of the medical practice professional working in ambulatory care settings today. From education and credentialing to emerging responsibilities and shifting practice trends, discover an illustrative look at the key personnel keeping medical practices going strong.
Benchmark of the Week
If you’ve been doing better on Medicare appeals lately, you’re part of a trend. Between 2013 and 2020, the overall rate of success for providers and suppliers on redeterminations, the first level of formal Medicare appeals on claims denials, rose from 46.5% to 55% at Part B Medicare administrative contractors (MACs). And Part B durable medical equipment (DME) claimants did even better.
With the annual CPT code release now out, you’ll find hundreds of new, revised and deleted codes coming your way (see related story, p. 1). With numerous codes expiring, prepare to shift to alternative options for dozens of services and procedures in 2022.

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